Provider Demographics
NPI:1063846160
Name:FRYE, LINDSEY SMITH (PHD)
Entity Type:Individual
Prefix:DR
First Name:LINDSEY
Middle Name:SMITH
Last Name:FRYE
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:209 W TRADE ST
Mailing Address - Street 2:
Mailing Address - City:SIMPSONVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29681-2609
Mailing Address - Country:US
Mailing Address - Phone:864-415-7153
Mailing Address - Fax:
Practice Address - Street 1:209 W TRADE ST
Practice Address - Street 2:
Practice Address - City:SIMPSONVILLE
Practice Address - State:SC
Practice Address - Zip Code:29681-2609
Practice Address - Country:US
Practice Address - Phone:864-415-7153
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-26
Last Update Date:2013-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC1159103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC1159OtherSC DEPT OF LABOR, LICENSING, AND REGULATION